{Serious Post Alert}
I am not one to pretend I know everything about the way the mind, or the body, or the world for that matter, works. But if there is one thing I know based on factual research, history of our culture, observations in society, and my own, anecdotal experiences, it is this: having a baby seriously fucks you up. It fucks up your body. It fucks up your sleep patterns. It fucks up your life as you knew it. And it fucks up your head.
Sometimes it really really fucks up your head.
So much so that there is an entire array of postpartum mental health disorders that you can find yourself diagnosed with. Postpartum depression. Postpartum psychosis. Postpartum anxiety. I am sure the list goes on.
The question is: why won’t anyone do anything about it?
Shortly *before* I had my third little ball of perfect, I started having major problems with anxiety and panic attacks. I was approximately 8 months pregnant, 34 years old, and all of a sudden I couldn’t handle going to the doctor. I would worry – excessively – in the days that led up to whatever appointment I had. Something was going to be wrong, I just knew it. Then when I got to the office, with absolutely nothing wrong, I would have a full blown panic attack. On several occasions, it rocketed my blood pressure up higher than it has ever been.
If you know anything about pregnancy, you know that high blood pressure is bad news.
It got to the point where my OB started me on a mild sedative to make it through the duration of the pregnancy. It worked, a little. While in the hospital, they gave me something else that was safe in breastfeeding, then sent me home saying that the hormones with breastfeeding would likely fix everything. And if it didn’t, call my primary care physician.
Since then, I have lived in a constant state of anxiety. Constant. Not a day goes by that I am not worrying about things I cannot control, making myself sick to my stomach from the fight-or-flight adrenaline rushing through my body, being angry about things I am not entirely sure anger is an appropriate response to, and having about one full blown panic attack a week.
This has gone on for 21 months now.
At first, I tried to deal with it, patiently but also impatiently (as anxiety has a tendency to draw minutes out into agonizing years). I thought to myself: you know what, I am sure when the breastfeeding gets going, it’ll help like they said.
When I went in for my six week c-section follow up, I mentioned that the anxiety had not gone away, so my doctor gave me the card for a psychologist who specialized in postpartum mental health.
She wasn’t in network for my insurance.
So I called my primary care physician, who – in short – did very little. Six months later, she gave me a prescription for Xanax with the side note that no you really shouldn’t take Xanax while breastfeeding – but she finished breastfeeding at six months, so maybe this would give me the incentive to quit breastfeeding at six months too. Then I could deal with my anxiety.
By taking boatloads of Xanax.
When I said that the World Health Organization recommends a minimum of two years breastfeeding, she said that the AAP only recommended six months to a year. So think about it, here’s the Xanax if you decide to wean.
I changed doctors.
Unfortunately, over the course of the following months, it’s been more of the same. Either a doctor doesn’t support breastfeeding beyond a year, or they don’t support treating a woman with postpartum anxiety, or they don’t support either.
My most recent doctor finally said: you know, there just really aren’t many options, why not give therapy a shot with someone that is in network.
So I went on the search for a local therapist that supports breastfeeding, deals with postpartum anxiety, is in network with my insurance, and is taking new patients.
Very few that meet all of that criteria exists.
So few, in fact, that it got down to one guy. One fucking guy. He called me back (which most of them didn’t even give me the courtesy of doing), he asked about what insurance I had, went over a little phone interview, then scheduled an appointment.
Here is how the appointment went, in a short list:
- {Appointment started 20 minutes late}
- “Oh hey – you said you have California Blue Shield? Yeah so…I’m out of network with them now. It’s August now, last week when we spoke it was July so… I’ll take your regular copay for now and then when I get the EOB in 90 days, we can just settle up whatever the difference ends up being for all the appointments. Cool?
- “So when do you plan to start weaning so you can take some medication? I just want a timeline to see what we are looking at here? OH you’re letting the baby decide? Huh…
- “Alright, if I have this straight, your husband works nights and you are alone with the kids…you say you get about 4 hours of sleep a night? Well you should do something about that, it’s probably making your anxiety worse.
- “I think you should consider this workbook about cognitive behavioral therapy…I mean it’s for teens but don’t think that means I think you are stupid. Well you are a stay at home mom HAHAHA, just kidding…it’s just a good workbook.
- {Appointment ended 10 minutes early, which – combined with the 20 minutes late, turned an hour into 30 minutes of paperwork and literally just the above comments}
So uncivilized.
I left horrified. And yet still I had scheduled a follow up visit, figuring I would give the guy another chance. I mean…I was at the point where he was literally the only therapist in a 50 mile radius that fit the bill.
But there was still that sticky insurance thing, so I called the insurance company and – long story short – out of network meant my weekly copay to see this pseudo-sexist quack was going to be $57 instead of the in network $10.
That would be $228 instead of $40 a month. An unreasonable difference that – honestly – was out of my copay budget and – frankly – not worth it. I’ll deal with the fucking worrying and upset stomachs for now. My baby – now a toddler – is 21 months old; it is very VERY likely this will begin to subside soon anyway. And if it doesn’t, by that point he will likely wean on his own and I can explore a safer non-narcotic medication approved for anxiety.
So I called the guy to cancel the appointment, explaining – what I thought politely – was that I had called the insurance and the copay was just going to be too high, and here was the TEXT MESSAGE he sent me, within minutes:
“Heather i will take you out of the book for friday. You are PPO fyi, and although you would likely pay some what more, it shouldn’t be exorbitant as you claimed.”
Okay.
At what point are we going to talk about maternal mental health, or mental health in general, and actually make the situation better? Or how about we just address the general lack of healthcare available for anything?
It is terrifying to think that so few doctors in my community want to actually doctor. It is even more terrifying to think that so few doctors in my community seem to be able to put their personal opinions and beliefs aside so they can assume their call of duty as practitioners of whatever specialty they chose.
To be honest with you all: the thought of going back to the drawing board with this therapist situation seems to have straightened my anxious head right up, anyway. Every time I start worrying, I think to myself now: Heather, the last thing you want to do is have to go back to a quack like that jerk that called stay at home moms dumb. Panic: away!
It’s 2018. We should be able to talk about this shit, and for that matter to be civilized about it. Not everyone is so lucky to be able to redirect their thoughts so easily as I seem to have. It is for those people that we need to have this discussion.
